Hypercalcemia

Definition

Hypercalcemia is too much calcium in the blood.

Causes

Calcium is important to many body functions, including:

Bone formation

Hormone release

Muscle contraction

Nerve and brain function

Parathyroid hormone (PTH) and Vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands, which are four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as:

Egg yolks

Fish

Fortified cereals

Fortified dairy products

Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth on one of the glands. (Most of the time, these growths are not cancerous).

Treatment

Treatment is aimed at the cause of hypercalcemia whenever possible. People with primary hyperparathyroidism (PHPT) may need surgery to remove the abnormal parathyroid gland. This will cure the hypercalcemia.

People with mild hypercalcemia may be able to monitor the condition closely over time.

Severe hypercalcemia that causes symptoms and requires a hospital stay may be treated with the following:

Calcitonin

Dialysis

Diuretic medication, such as furosemide

Drugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate (bisphosphonates)

Fluids through a vein (intravenous fluids) - this is the most important therapy

Glucocorticoids (steroids)

Outlook (Prognosis)

How well you do depends on the cause of hypercalcemia. The outlook is good for people with mild hyperparathyroidism or hypercalcemia with a treatable cause. Most of the time, there are no complications.

Patients with hypercalcemia due to conditions such as cancer or granulomatous disease may not do well. This is most often due to the disease itself, rather than the hypercalcemia.